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PubMed2001

Spinal manipulation causes variable spine kinematic and trunk muscle electromyographic responses.

STUDY DESIGN: Analytic cohort with a convenience sample in a research clinic. OBJECTIVES: To determine the influence of a spinal manipulation on trunk kinematics and associated trunk myoelectric activity. SUMMARY OF BACKGROUND: While the mechanism of spinal manipulation is unknown, it has been theorized to influence spinal range of motion and trunk muscle activity. METHODS: Trunk kinematics were measured in low back pain patients (n = 14) during simple range of motion tasks in three planes, while trunk muscle electromyogram signals were recorded bilaterally from paraspinal and abdominal musculature. Kinematics and electromyogram signals were assessed pre-post manipulation. Electromyogram activity was also assessed pre-post manipulation during quiet stance. RESULTS: While no consistent kinematic or electromyographic changes occurred following manipulation across the population, individual changes were observed. The largest changes (> 6 degrees ) in range of motion occurred in the sagittal plane of three patients experiencing the greatest amount of pain. During quiet stance 17 muscles across all subjects exhibited changes in muscle activity following manipulation. Sixteen of those changes were decreases in muscle amplitude. CONCLUSIONS: This study offers some preliminary data on the short-term effects of manipulation on lumbar range of motion and dynamic electromyogram. The findings suggest that the response to manipulation is variable and dependent on the individual, with no change in some to the largest changes seen in the more pained patients. Relevance. Basic science investigations into the mechanisms and biomechanical influences of spinal manipulation are few. This study attempts to address issues of measureable functional change with manipulative therapy.

Adult↗

PubMed2000

Factor structure of trunk performance data for healthy subjects.

OBJECTIVE: To examine the factor structure of various measurements of trunk muscle performance for healthy subjects. DESIGN: A total of 22 performance scores were collected and their univariate and multi-variate relationships were examined. BACKGROUND: Extensive literature exists on the measurement of trunk performance data and the relationships between measurements but what needs to be collected to realize a true performance score remains unclear. METHODS: Trunk muscle performance scores of 150 subjects (71 males and 79 females) were obtained on an Isostation B-200 Dynamometer. Twenty-two parameters measuring range of motion, isometric strength, velocity, and endurance on all three planes of motion were collected. The factor structures were constructed using Principal Components Analysis. RESULTS: Clear-cut factor patterns (explained 96.3% of the total variance) suggests that the five-factor structure might be valid and appropriate for this population. The major loading on each factor indicated that: Factor 1 could be labeled as a static strength measure; Factor 2 as velocity; Factor 3 as flexibility; and Factors 4 and 5 as fatigue-resistance. CONCLUSIONS: No single mode of measurement can provide a good representation of a total trunk muscle performance. RelevanceFor the realization of trunk muscle performance, clinics have to measure all modes of isometric strength, velocity, range of motion, and endurance. Care must be taken in eliminating any parameter.

Adult↗

PubMed2003

Trunk- and head-centred spatial coordinates do not affect free-viewing perceptual asymmetries.

Turning the trunk or head to the left can reduce the severity of leftward neglect. This study sought to determine whether turning the trunk or head to the right would reduce pseudoneglect: A phenomenon where normal participants underestimate the rightward features of a stimulus. Participants made luminance judgements of two mirror-reversed greyscales stimuli. A preference for selecting the stimulus dark on the left was found. The effect of trunk-centred coordinates was examined in Expt. 1 by facing the head toward the display and turning the trunk to the left, right or toward the display. Head-centred coordinates were examined in Expt. 2 by directing the eyes toward the display and then turning the head and trunk. No effect of rotation was observed. It was concluded that the leftward bias for the greyscales task could be based on an object-centred attentional bias or left-to-right eye scanning habits.

Adolescent↗

PubMed1996

Is the center of gravity controlled during upper trunk movements?

The question was addressed in this study as to whether the kinematic synergy responsible for equilibrium control during upper trunk movements may involve an actual evaluation of the weight of the body segments. Five adult subjects were asked to bend the upper trunk forward or backward to an angle of about 35 degrees, first without any load and then with a 10 kg load fixed to their shoulders. The center of gravity (CG) shift in the sagittal direction which occurred at the end of the movement was compared versus without a load. Two patterns of CG shift were identified. In the first pattern shown by three subjects in forward and three in backward trunk bending, the CG shift remained the same, while in the other pattern (two subjects for forward and two for backward trunk bending), the CG shift increased by an amount corresponding to the purely mechanical effect of the load. These results indicate that the actual weight of the segments may be evaluated on the basis of sensory inputs and may be responsible for a change in the kinematic synergy which preserves the CG control during the upper trunk movement.

Adaptation, Physiological↗

PubMed2001

Functional roles of abdominal and back muscles during isometric axial rotation of the trunk.

Electromyographic (EMG) studies have shown that a large number of trunk muscles are recruited during axial rotation. The functional roles of these trunk muscles in axial rotation are multiple and have not been well investigated. In addition, there is no information on the coupling torque at different exertion levels during axial rotation. The aim of the study was to investigate the functional roles of rectus abdominis, external oblique, internal oblique, latissimus dorsi, iliocostalis lumborum and multifidus during isometric right and left axial rotation at 100%, 70%, 50% and 30% maximum voluntary contractions (MVC) in a standing position. The coupling torques in sagittal and coronal planes were measured during axial rotation to examine the coupling nature of torque at different levels of exertions. Results showed that the coupled sagittal torque switches from nil to flexion at maximum exertion of axial rotation. Generally, higher EMG activities were shown at higher exertion levels for all the trunk muscles. Significant differences in activity between the right and left axial rotation exertions were demonstrated in external oblique, internal oblique, latissimus dorsi and iliocostalis lumborum while no difference was shown in rectus abdominis and multifidus. These results demonstrated the different functional roles of trunk muscles during axial rotation. This is important considering that the abdominal and back muscles not only produce torque but also maintain the spinal posture and stability during axial rotation exertions. The changing coupling torque direction in the sagittal plane when submaximal to maximal exertions were compared may indicate the complex nature of the kinetic coupling of trunk muscles.

Abdominal Muscles↗

PubMedDate not supplied

Trunk-specific modulation of wingless signalling in Drosophila by teashirt binding to armadillo.

BACKGROUND: One function of the Wingless signal cascade is to determine the 'naked' cuticle cell-fate choice instead of the denticled one in Drosophila larvae. Wingless stabilises cytoplasmic Armadillo, which may act in a transcriptional activator complex with the DNA-binding protein T-cell factor (also known as Pangolin). As these components are critical for all Wingless-dependent patterning events, the problem arises as to how specific outputs are achieved. RESULTS: The Teashirt zinc finger protein was found to be necessary for a subset of late Wingless-dependent functions in the embryonic trunk segments where the teashirt gene is expressed. Teashirt was found to be required for the maintenance of the late Wingless signalling target gene wingless but not for an earlier one, engrailed. Armadillo and Teashirt proteins showed similar Wingless-dependent modulation patterns in homologous parts of each trunk segment in embryos, with high levels of nuclear Teashirt and intracellular Armadillo within cells destined to form naked cuticle. We found that Teashirt associates with, and requires, Armadillo in a complex for its function. CONCLUSIONS: Teashirt binds to, and requires, Armadillo for the naked cell-fate choice in the larval trunk. Teashirt is required for trunk segment identity, suggesting that Teashirt provides a region-specific output to Armadillo activity. Further modulation of Wingless is achieved in homologous parts of each trunk segment where Wingless and Teashirt are especially active. Our results provide a novel, cell-intrinsic mechanism to explain the modulation of the activity of the Wingless signalling pathway.

Animals↗

PubMed2003

Trunk muscle onset detection technique for EMG signals with ECG artefact.

The timing of trunk muscle activation has become an important element in the understanding of human movement in normal and chronic low back pain populations. The detection of anticipatory postural adjustment via trunk muscle onsets from electromyographic (EMG) signals can be problematic due to baseline noise or electro-cardiac (ECG) artefact. Shewhart protocols or whole signal analyses may show different degrees of sensitivity under different conditions. Muscle activity onsets were determined from surface EMG of seven muscles for five trials before and after fatigue were examined in four subjects (n=280). The objective of this study was to examine two detection methods (Shewhart and integrated protocol (IP)) in determining the onsets of trunk muscles. The variability of the baseline amplitude and the impact of added Gaussian noise on the detected onsets were used to test for robustness. The results of this study demonstrate that before and after fatigue there is a large degree of baseline variance in the trunk muscles (coefficients of variation between 40-65%) between trials. This could be normal response to body sway. The IP method was less susceptible to false onsets (detecting onsets in the baseline window) 3 vs. 51%. The findings suggest the IP method is robust with large variance in the baseline if the signal to noise ratio is greater than six. In spite of the robustness of the algorithm, the findings would suggest that statistical assessments should be used to target trials for selective visual inspection for subtle trunk muscle onsets.

Abdominal Muscles↗

PubMed2003

Increasing esophageal length: a comparison of laparoscopic versus transthoracic esophageal mobilization with and without vagal trunk division in pigs.

BACKGROUND: New laparoscopic techniques allow both mediastinal mobilization and performance of a Collis gastroplasty when necessary, and the utility of a transthoracic approach is questioned. The aim of this study was to compare the increase in esophageal length achievable with laparoscopic and transthoracic esophageal mobilization in pigs, and to assess the impact of vagal trunk division on esophageal length. STUDY DESIGN: Baseline esophageal length was obtained in 20 farm pigs by measuring the distance between a stitch placed in the esophagus to a K-wire placed in a vertebral body. Subsequently, laparoscopic and then transthoracic mediastinal mobilization of the esophagus were performed in 15 pigs and the length gain after each procedure recorded. In 7 of 15 animals, the vagal nerve trunks were divided after esophageal mobilization and the increase in esophageal length measured. In five animals, vagal trunk division was performed without earlier esophageal mobilization. RESULTS: Esophageal length gain after laparoscopic mobilization (median 4 mm) was significantly less than that after transthoracic mobilization (median 12 mm, p < 0.0001). Unilateral vagal nerve transection resulted in a median 2.5 mm of esophageal length gain compared with a median of 6.25 mm with division of both vagal trunks. Maximal esophageal lengthening (median 18.5 mm) occurred with a combination of esophageal mobilization and bilateral vagal trunk division. CONCLUSIONS: Esophageal length gain after transthoracic mobilization in normal pigs is significant, and would likely be even greater in patients with gastroesophageal reflux disease with concomitant mediastinal inflammation. Transthoracic mobilization alone likely will allow successful reduction of the gastroesophageal junction below the diaphragm in many patients who might otherwise require a Collis gastroplasty.

Animals↗

PubMed2001

Decaying wood in tree trunk hollows as a natural substrate for Cryptococcus neoformans and other yeast-like fungi of clinical interest.

The occurrence of Cryptococcus neoformans var. neoformans and other yeast-like fungi of clinical interest in decaying wood inside tree trunk hollows, bark and other plant materials is reported. The var. neoformans was isolated from 3 of 45 (6.6%) wood and one of 390 Eucalyptus bark samples. Two of the positive wood samples came from a tree trunk hollow of Butea monosperma (Family: Papilionaceae) growing in Roshan Ara Garden, Old Delhi whereas the third was from a trunk hollow of Tamarindus indica (Family: Papilionaceae) growing outside of Talkatora Garden, New Delhi. The solitary positive Eucalyptus bark sample originated from Amritsar. The isolations of var. neoformans from decaying wood inside trunk hollows of B. monosperma and T indica constitute the first record of the natural occurrence of this pathogen in association with these trees. The observation reinforces the recent evidence for decaying wood inside trunk hollows of some trees to be a new natural habitat of the variety neoformans. Besides, in consonance with their essentially saprobic character, a number of other yeast-like fungi were sporadically isolated. This includes, Cryptoccus laurentii, Cryptococcus albidus, Candida lusitaniae, C. guilliermondii, C. krusei, C. tropicalis, C. zeylanoides, Trichosporon cutaneum, Rhodotorula mucilaginosa, R. glutinis, Geotrichum capitatum, G. klebahnii and Sporobolomyces salmonicolor. Cryptococcus neoformans var. gattii was not found in any of the 702 samples of plant materials, including the bark and detritus of Eucalyptus camaldulensis and E. tereticornis trees. A more extensive environmental survey, covering divergent climatic regions, is warranted to identify the natural reservoirs of var. gattii in India.

Cryptococcus neoformans↗

PubMed2003

"Right-trunkers" and "left-trunkers": side preferences of trunk movements in wild Asian elephants (Elephas maximus).

In this article, the side preferences of feeding-related trunk movements of free-ranging Asian elephants (Elephas maximus) were investigated for the first time. It is hypothesized that a functional asymmetry of the trunk is necessary to perform skillful feeding movements more efficiently. This might be connected with a corresponding hemispheric specialization. Video recordings of 41 wild elephants provided frequencies and durations of the following trunk-movement categories: object contact, retrieval, and reaching. In each category, individual side preferences were found. The strength of side preferences varied between the trunk-movement categories and the sexes. Mean durations of retrieval and reaching correlated negatively with the strength of side biases. Comparing the side preferences in the unpaired trunk with analogous phenomena in other unpaired grasping organs and in primate handedness. the authors discuss possible explanations for the evolution of asymmetries in unpaired grasping organs.

Animals↗

PubMed2005

Opposite contributions of trunk and leg fat mass with plasma lipase activities: the Hoorn study.

OBJECTIVE: Lipoprotein lipase (LPL) and hepatic lipase (HL) are essential in hydrolysis of triglyceride-rich lipoproteins. LPL activity is negatively, whereas HL activity is positively, associated with total body fat. We determined the associations of trunk and leg fat mass with plasma LPL and HL activities in a cross-sectional study. RESEARCH METHODS AND PROCEDURES: LPL and HL activities were determined in post-heparin plasma in a sample of 197 men and 209 women, 60 to 87 years of age. A total body DXA scan was performed to determine trunk and leg fat mass. RESULTS: In women, but not in men, trunk fat mass was negatively associated with LPL activity, whereas leg fat mass was positively associated, after mutual adjustment and adjustment for age. Standardized betas (95% confidence interval) for trunk and leg fat mass were -0.24 (-0.41; -0.08) and 0.14 (-0.02; 0.31), respectively (interaction by sex, p = 0.03). Larger trunk fat mass was associated with higher HL activity in men [0.48 (0.28; 0.68)] and women [0.40 (0.24; 0.56)]. A negative association of leg fat mass and HL activity was observed in men, although not statistically significant [-0.13 (-0.33; 0.06)], and in women [-0.28 (-0.38; -0.18)]. DISCUSSION: Abdominal fat is associated with unfavorable and femoral fat with favorable LPL and HL activities in plasma.

Abdominal Fat↗

PubMed2006

Effect of obesity on posture and hip joint moments during a standing task, and trunk forward flexion motion.

OBJECTIVE: Effects of obesity on trunk forward flexion motion in sitting and standing, and postural adaptations and hip joint moment for a standing work task. DESIGN: Cross-sectional comparison of obese and normal weight groups. SUBJECTS: Ten obese subjects (waist girth 121.2+/-16.8 cm, body mass index (BMI) 38.9+/-6.6 kg m(-2)) and 10 age- and height-matched normal weight subjects (waist girth 79.6+/-6.4 cm, BMI 21.7+/-1.5 kg m(-2)). METHODS: Trunk motion during seated and standing forward flexion, and trunk posture, hip joint moment and hip-to-bench distance during a simulated standing work task were recorded. RESULTS: Forward flexion motion of the thoracic segment and thoracolumbar spine was decreased for the obese group with no change in pelvic segment and hip joint motion. Obese subjects showed a more flexed trunk posture and increased hip joint moment and hip-to-bench distance for a simulated standing work task. CONCLUSIONS: Decreased range of forward flexion motion, differing effects within the trunk, altered posture during a standing work task and concomitant increases in hip joint moment give insight into the aetiology of functional decrements and musculoskeletal pain seen in obesity.

Adult↗

PubMed2002

Trajectories of target reaching arm movements in individuals with spinal cord injury: effect of external trunk support.

DESIGN: Deficits in trunk control due to spinal cord injury (SCI) lead to slower target-reaching movements of the hand. We investigated whether the movement path is also affected, and whether providing external support for the trunk can abolish the kinematic differences. OBJECTIVE: To compare movement trajectories between individuals with SCI and neurologically normal individuals, with and without external trunk support. SETTING: Neural Control/Biomechanics Laboratory, University of Illinois, Chicago, USA. METHODS: Five subjects with levels of injury between C7 and T4 were tested 3-8 years post-injury, and compared with five control subjects. Two targets were employed. Trajectories were recorded by a motion-capture system using infrared emitting markers. Peak speed and path curvature were calculated for the fingertip and for the acromion. RESULTS: Compared with control subjects, the subjects with SCI exhibited lower peak speed of the fingertip but not of the acromion, and less straight paths for both. When the trunk was supported externally, the difference in fingertip speed persisted. The support abolished the difference in path curvature for the fingertip but accentuated that for the acromion. CONCLUSION: The slower hand movements of individuals with SCI are not simply time-scaled versions of those of normal subjects, and the provision of trunk support does not erase the kinematic differences between the reaching movements of the two groups.

Acromion↗

PubMed2006

Heat-provoked skin vasodilatation in innervated and denervated trunk dermatomes in human spinal cord injury.

STUDY DESIGN: Cross-sectional, observational, controlled study. OBJECTIVE: High spinal cord injury (SCI) results in disruption of sympathetic vasomotor control. Vasodilatation as a response to local heating is a biphasic mechanism: the first phase (neurogenic) is mediated by the axon-reflex and is modulated by activity of sympathetic nerves. Our objective was to determine whether the response to heat provocation in trunk dermatomes may provide a measure of vasomotor sympathetic function in SCI. SETTING: National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire, UK; Autonomic Unit, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Neurovascular Medicine Unit, Imperial College London at St Mary's Hospital, UK. SUBJECTS: A total of 30 subjects were studied; 18 had chronic complete SCI (level C6-T11) and 12 were healthy controls. METHODS: Recordings of skin blood flow (SkBF) were obtained with thermostatic laser Doppler probes placed in the upper trunk (at C4) and lower trunk (T10 or T12) dermatomes. RESULTS: SkBF at baseline (SkBF(bas)) and SkBF at the first peak of vasodilatation (SkBF(max)) showed no significant differences between SCI and controls either in upper or lower trunk dermatomes. However, the ratio of SkBF(max)/SkBF(bas) was significantly different in lower trunk dermatomes in SCI at C6-T5 level (7.5+/-3.5 PU) compared to SCI at T6-T11 level (3.5+/-1.5 PU) (P < 0.01). CONCLUSION: Measurement of SkBF in response to local heating may provide a safe, noninvasive method to assess integrity of sympathetic spinal pathways to the local vasculature. This may aid the classification of the SCI lesions, as the autonomic component currently is not included in the accepted American Spinal Injury Association scoring.

Adult↗

PubMed2002

Does celiac trunk stenosis correlate with anastomotic leakage of esophagogastrostomy after esophagectomy?

The formation of a gastric tube for esophageal replacement requires partial devascularization of the stomach and induces microcirculatory changes in the anastomotic region of the gastric fundus. The additional influence of celiac trunk stenosis on anastomotic healing has not been investigated. In total, 23 patients with an esophageal carcinoma underwent transthoracic esophagectomy. Reconstruction was performed by a gastric tube (x22) with cervical or thoracic esophagogastrostomy or colon interposition (x1). All patients had a selective mesenterico-celiacography preoperatively via puncture of the right femoral artery. Preoperative cardiovascular and pulmonary risk factors were assessed. Angiographic findings were correlated to postoperative anastomotic leakage of esophagogastrostomy (x22). In seven out of 23 patients (30.4%), a stenosis of the celiac trunk could be demonstrated (x3 stenosis of 50%, x4 stenosis > 80%). Except for one patient with an additional stenosis of the superior mesenteric artery of > 80%, none of the patients with celiac trunk stenosis developed a postoperative anastomotic leakage of the esophagogastrostomy. Coronary artery disease was the only preoperative risk factor to predict a stenosis of the celiac trunk. Isolated stenosis of the celiac trunk does not seem to impair circulation of the gastric tube.

Adult↗

PubMed2001

Trunk muscle fatigue during a back extension task in standing.

There is some evidence that the fatiguing characteristics during isometric back extension tasks may assist in identifying differences between individuals with and without low back pain (LBP). During these tasks, especially in standing, other abdominal trunk muscles are also active. The abdominal trunk muscles acting across multiple segments of the lumbar spine function in isolation or in synergy to create flexion torques. It is suggested that co-activation patterns of the trunk muscles are able to control the axis of rotation of the extension torque and also provide multi-segmental stability of the spine. The purpose of this study was to examine the fatigue responses in 4 asymptomatic individuals to a sustained isometric extension task of the trunk muscles evaluating the shifts in the median frequency of the electromyographic (EMG) signal. This study suggests that in asymptomatic subjects, the more superficial abdominal muscles (External Oblique and Rectus Abdominis) increased in activity as the test progressed. There was large inter-individual variation in both amplitude and median frequency changes. Rectus abdominis and the back extensors demonstrated characteristics of fatigue during the task. Studies to test for any characteristic trends in whether specific trunk muscles fatigue in standing is a feature in chronic LBP, invites a formal investigation.

Abdominal Muscles↗

PubMed1996

The meningohypophyseal trunk and its blood supply to different intracranial structures. An anatomical study.

50 meningohypophyseal trunks of the intracavernous internal carotid artery were studied in 25 human cadavers. Special attention was given to the main variations of branching patterns of this trunk. The dorsal meningeal arteries were found in all cases and three typical variations were observed in their origins and courses: a prominent medial branch (52%), a bifurcating type (38%) or a single lateral branch was present (10%). The tentorial artery of Bernasconi-Cassinari arised as a single branch in 64% of the cases, while in 36% two or more branches took a direct origin from the main trunk. The inferior hypophyseal artery was prominent in 82% of the cases. The inferolateral trunk had a common origin with the meningohypophyseal trunk in 8% of our dissections. A large number of anastomoses between these vessels was observed. As a number of tumorous and vascular pathologies, which can be treated with microsurgical techniques, take their origin from the cavernous sinus, the knowledge of the smaller vessels arising from the intracavernous internal carotid artery as well as their main variations is important.

Adult↗

PubMedDate not supplied

Mechanical force spinal manipulation increases trunk muscle strength assessed by electromyography: a comparative clinical trial.

OBJECTIVE: The objective of this study was to determine whether mechanical force, manually-assisted (MFMA) spinal manipulative therapy (SMT) affects paraspinal muscle strength as assessed through use of surface electromyography (sEMG). DESIGN: Prospective clinical trial comparing sEMG output in 1 active treatment group and 2 control groups. SETTING: Outpatient chiropractic clinic, Phoenix, AZ. SUBJECTS: Forty subjects with low back pain (LBP) participated in the study. Twenty patients with LBP (9 females and 11 males with a mean age of 35 years and 51 years, respectively) and 20 age- and sex-matched sham-SMT/control LBP subjects (10 females and 10 males with a mean age of 40 years and 52 years, respectively) were assessed. METHODS: Twenty consecutive patients with LBP (SMT treatment group) performed maximum voluntary contraction (MVC) isometric trunk extensions while lying prone on a treatment table. Surface, linear-enveloped sEMG was recorded from the erector spinae musculature at L3 and L5 during a trunk extension procedure. Patients were then assessed through use of the Activator Methods Chiropractic Technique protocol, during which time they were treated through use of MFMA SMT. The MFMA SMT treatment was followed by a dynamic stiffness and algometry assessment, after which a second or post-MVC isometric trunk extension and sEMG assessment were performed. Another 20 consecutive subjects with LBP were assigned to one of two other groups, a sham-SMT group and a control group. The sham-SMT group underwent the same experimental protocol with the exception that the subjects received a sham-MFMA SMT and dynamic stiffness assessment. The control group subjects received no SMT treatment, stiffness assessment, or algometry assessment intervention. Within-group analysis of MVC sEMG output (pre-SMT vs post-SMT sEMG output) and across-group analysis of MVC sEMG output ratio (post-SMT sEMG/pre-SMT sEMG output) during MVC was performed through use of a paired observations t test (POTT) and a robust analysis of variance (RANOVA), respectively. MAIN OUTCOME MEASURES: Surface, linear-enveloped EMG recordings during isometric MVC trunk extension were used as the primary outcome measure. RESULTS: Nineteen of the 20 patients in the SMT treatment group showed a positive increase in sEMG output during MVC (range, -9.7% to 66.8%) after the active MFMA SMT treatment and stiffness assessment. The SMT treatment group showed a significant (POTT, P < 0.001) increase in erector spinae muscle sEMG output (21% increase in comparison with pre-SMT levels) during MVC isometric trunk extension trials. There were no significant changes in pre-SMT vs post-SMT MVC sEMG output for the sham-SMT (5.8% increase) and control (3.9% increase) groups. Moreover, the sEMG output ratio of the SMT treatment group was significantly greater (robust analysis of variance, P = 0.05) than either that of the sham-SMT group or that of the control group. CONCLUSIONS: The results of this preliminary clinical trial demonstrated that MFMA SMT results in a significant increase in sEMG erector spinae isometric MVC muscle output. These findings indicate that altered muscle function may be a potential short-term therapeutic effect of MFMA SMT, and they form a basis for a randomized, controlled clinical trial to further investigate acute and long-term changes in low back function.

Adult↗